This project is funded under the Robert Wood Johnson Foundation’s Research in Transforming Health and Healthcare Systems (RTHS) program, which supports policy-relevant, community-engaged research on current or potential policies to transform health and health care systems. The goal of the study is to provide specific, community-driven, measurable, and Tribally rooted recommendations needed for meaningful innovation in the Indian Health Service (IHS) that will result in more affordable and accessible care to Tribal nations and improve health equity. The study seeks to create an estimate for full funding of the IHS to inform how to improve affordability and access to high-quality IHS-funded health care to achieve health equity for American Indian and Alaska Native people. To date, efforts by the federal government to honor the trust and treaty obligations for health care have been insufficient, as severe and persisting health disparities exist today among Tribal communities. The project team will form an advisory group comprised of sovereign leaders of federally recognized Tribal nations, and collaborate with Area Indian Health Boards (AIHBs), Tribal Epidemiology Centers (TECs), and the National Tribal Budget Formulation Work Group Meetings (NTBFWG).
The proposed approach will provide detailed information on the existing disparities in health risks and service use for the American Indian and Alaska Native population. Individuals with different insurance types (Medicaid, uninsured, and Medicare or dually eligible) will be analyzed within the distinct data sources associated with their insurance and/or IHS treatment system. This process will ascertain a comprehensive picture of current health risks and service use and provide insight into the types of care individuals eligible for IHS services are traveling substantial distances to obtain. In partnership with Mathematica, the project team will estimate a risk score that indicates the funding needed to meet the health care needs of the individuals in the American Indian and Alaska Native population compared to the national average for non-Native individuals with the same demographics. Deliverables will include a project work plan and annual and final narrative and financial reports, as well as a range of products to reach policymakers and other audiences for study findings.